Clifton Alexander, left, a certified marketplace navigator with the Urban League of Union County, helps Kalpesh Shah, 45, of Iselin choose a health plan on March 18 in Elizabeth.Patti Sapone/The Star-Ledger

These were long-standing clients who were in the middle of treatments for things like cancer, diabetes, heart disease, kidney disease and other debilitating illnesses. The panic they demonstrated was unbelievable but understandable.

This turmoil could have been avoided. So why wasn’t it? No one seemed to have an answer. Moreover, getting someone to answer the telephone so we might ask questions was impossible.

Why didn’t they just set up a system for healthcare.gov such that if your last name begins with “A-L,” you could call or log in on Mondays and Tuesdays, while those whose names begin with “M-Z” could do the same on Wednesdays and Thursdays? Not complex enough for the government, I guess.

The next day came the calls from my small-business clients. On their insurance renewal dates, they were being forced to change to an ACA-conforming plan. Some of these clients were being told they would see a rate increase of up to 85 percent.

In cases where a husband and wife are the whole “business” — the only ones on the payroll — they were no longer considered a “group” and their health insurance policies were being canceled.

“So, what am I supposed to do? I can’t afford what I am paying now so, how can I afford this?” they would ask.

For many small-business owners, health insurance premiums jumped 25 to 50 percent. For others, the increase was even more. One of my clients said, “This is criminal. I can’t afford to pay up to $2,200 per month. And this is supposed to be the Affordable Care Act?”

Other questions abound. Is my doctor in the network? Does he accept this new ACA plan? Do I have to change doctors? How will I know if the new doctor accepts the plan? And on, and on, and on ... .

Even if your doctor participates in the ACA program, he or she may not accept the individual plan you select. And, by the way, be sure to find out what your co-pay and/or deductable is before you visit an emergency room. Some patients may be responsible for the first $2,000 or more of their care, even if the hospital accepts their particular plan.

Another hidden ACA impact is that insurance companies have been inundated with new rules and responsibilities. What used to take but a few minutes to accomplish on the telephone with your insurance company may now take weeks to complete.

Who are the winners in all of these changes? Perhaps the medically under-served are better off, especially if they have a pre-existing condition. But, that’s kind of like not buying automobile insurance until after you’ve had an accident and expecting the policy you buy to cover your injuries and damages from that accident. No wonder the insurance companies are in a muddle.

Who pays for all these changes? It appears the financial burden falls squarely on the backs of all those who are working hard to support their own families. Many are now being asked to pay higher premiums so that all of those who are uninsured or “uninsurable” will have access to health care.

The cost of insurance is based on a lot of things, and one of them is a “balance pool.” The idea being that, for health insurance, if you enroll enough young, usually healthy, people into the risk pool, it will balance the higher costs for the chronically ill and the elderly. This would be true if the younger people were actually paying an equal premium, but that is not what is happening.

Younger participants, with lower incomes, are receiving tax credits or subsidies, or being put on government-supported Medicaid. So, it is unclear how this helps to prevent waves in the balance pool.

It’s just another form of redistribution of wealth in this country, which seems to be the real agenda in Washington these days.

Please don’t show me another commercial with some young person getting health insurance at an “affordable price,” unless you are also going to show me a working person paying for it.

Brian Zimmerman of BZI Group of Deptford Township has been an insurance broker for 25 years.